Tuesday, December 8, 2009

What's Lost In Compromising

(Update 9:02 p.m. MST: The AP is reporting that the Democrats have reached a deal that would drop the public option from the health care reform bill currently being considered by the Senate.)

The latest conversation taking place in the halls of the United States Senate about health care reform seems to center around a compromise that would allow more Americans to enroll in Medicare. Democrats struggling to reach the sixty vote threshold required for passage are open to the idea of changing the enrollment age for Medicare to 60 years old, if not younger, and Republicans suddenly, though certainly not historically, supportive of Medicare are not openly opposing such a change if the leadership can prove it won't cause the collapse of Medicare.

Though very little negative is being said about this new option or Medicare in general, those of us not in the age group that this type of deal would help are left scratching our heads. Wasn't the goal of health care reform to make health care affordable and accessible to all Americans? How does forcing competition in the market for the 55 or older crowd by introducing Medicare as a competitor result in any sort of lowered cost for the 55 and younger crowd? Senators are expressing their concern for the 45-50 crowd amidst this latest news, but nobody seems to be concerned with the large number of Americans that still need the public option.

It is unclear this morning whether the idea of lowering the age for Medicare, an idea confirmed last night by Senator Rockefeller, is simply an attempt to appease progressive Democrats who would prefer single-payer or a robust public option. Some suggest that a buy-in to Medicare for those in the 55-65 age group should be a discussion for later days, days when it is clear that there is absolutely no chance of a public option (with or without triggers, an opt-out clause, language that would turn the clock back on a woman's right to choose or any other number of ridiculous compromises that have been thought up by spineless senators who are stalling, ignoring the true will of the people, or simply feeding their colossal egos) surviving on final passage.

All of this wrangling, the constant compromises and the partisan bickering on the floor of the Senate is only wearing on Americans. Some are watching and taking in the constant lies the Republicans are offering, fearful that they'll lose whatever coverage, however poor, that they currently have. Some are seeing the clips on the evening news and simply turning the other way rather than listen to the ridiculous partisanship. Then there are others, I'm afraid quite a few Americans fall into the category of apathetic. Weeks and months of health care debate has only left them numb. There are those who haven't heard a word of the debate and don't speak of it as if it is going to be the end of the world if health care reform passes and then there are those who haven't heard the debate or have listened to the factually deprived ravings on Fox News, and speak of health care reform as if it is, well, we don't even need to categorize this, they do say that it is going to kill grandma, there will be rationing of care, Medicare will collapse because its funding will be redirected to the inevitable government takeover of health care. It is tiring, tiring for all Americans and even tiring for those among us who watch the debate and read about it daily.

President Obama and the Democrats probably should have started the health care debate with the idea of a single-payer system so that the compromises may have left them with some sort of public option instead. Starting with a public option inevitably means, with the current level of partisanship and number of unavoidable compromises, that we will end up with something less than the public option. A robust public option was thrown out the window on day one.

Hopefully this latest conversation about changing the age Americans can enroll or buy into Medicare will not push from the minds of the Democrats that there are millions of Americans who won't be eligible for Medicare, make too much money to be eligible for Medicaid though not enough money to afford decent health insurance coverage, or face other roadblocks in attaining health insurance.

The legislation must do something about the cost of prescription drugs, perhaps exactly what a coming amendment will propose--opening the United States to drugs from Canada and European countries. The legislation must do something about the discriminatory practices that insurance companies employ--practices like denying coverage based on pre-existing conditions and charging women higher premiums than men, men of the same age and in similar health. The legislation must also address the practice of denying patients the opportunity to purchase health insurance across state lines.

Without a public option, it may be impossible for this legislation to get the costs down. A public option would create competition in the market, forcing insurance companies to offer reasonable plans with reasonable premiums. And a public option would offer Americans the chance to be insured if they've exhausted all other means. The current discussion about lowering the Medicare age does not fix any of these problems and the majority party would be wise to avoid tunnel vision at this point. There are too many Americans being left out in this unending series of compromises.

No comments :